Traumatic left diaphragmatic rupture associated with a splenic injury secondary to a blunt abdominal trauma: A case report and literature review.

INTRODUCTION AND

IMPORTANCE

A diaphragmatic rupture is an uncommon injury resulting from blunt abdominal trauma, and it rarely occurs alongside a splenic injury. Its diagnosis can even be difficult with advanced imaging; Complications from diaphragmatic rupture are severe and may even lead to death. A timely diagnosis can be life-saving.

CASE PRESENTATION: We report a case involving a 28-year-old male diagnosed with a diaphragmatic injury resulting from blunt abdominal trauma. A laparotomy was performed due to the deterioration of the patient's condition, which revealed an associated grade three splenic injury. The diaphragmatic defect was repaired, and a splenectomy was carried out.

CLINICAL DISCUSSION: A CT scan is a valuable tool that can identify even overlooked diaphragmatic injuries. However, when a CT scan is not available, a chest X-ray (CXR) serves as the first routine investigation for torso trauma. When combined with a comprehensive clinical examination, it can help detect underlying issues. If the patient's condition does not improve, exploration may be necessary. We suspect that herniated abdominal organs in the chest are compressing the spleen, which could be delaying the onset of shock.

CONCLUSION

Diaphragmatic rupture is rare, but clinicians should be vigilant in cases of blunt abdominal trauma. A thorough clinical examination and appropriate investigations can help diagnose it. If the patient's condition worsens, surgical exploration may be necessary to identify and manage underlying issues. Some injuries might also be found during surgery. The patient had an uneventful recovery.